Building a master index of patients Sequoia aims to make medical data more widely available

Armed with a federal advanced-technology award of nearly $2 million, Columbia's Sequoia Software is attempting to solve the vexing problem of creating a national "master patient index."

The index would help a doctor treating a patient to find and read other records related to that patient, even if they are stored on the incompatible computer systems of a hospital, lab or another doctor.

The 40-employee firm, which is No. 15 on the "Fast 50" list based on revenue growth among high-tech companies in Maryland, hopes to double in size by the end of next year, both with the patient index problem and to handle other growth.

Health data companies come in different flavors. Some, such as VIPS in Towson and NeighborWare in Baltimore, create systems to do billing and other record-keeping and clerical chores. Some, such as HCIA in Baltimore, create tools for analysis, allowing hospitals and other providers to compare their performance against national benchmarks.

Sequoia is in a different niche of the health data market. "We build engines or components," says Mark Wesker, Sequoia's president. "We don't decide what to collect;, we don't analyze."

So its goal is not to sell anyone a "Sequoia system" to do anything. Rather, it licenses pieces of software. Its largest installation so far is in a system built by the Kaiser Permanente HMO in Ohio to allow all its medical sites to exchange records.

Last week the firm announced an agreement with Datex-Engstrom Division of Instrumentarium Corp. of Finland, which will license Sequoia's software for use with its anesthesia and intensive-care monitoring equipment.

Sequoia is trying to extend its one-computer-talking-to-another technology to an even more complicated area.

Building the patient index is really three separate problems.

First, different computer systems must be able to talk to each other. Wesker says there's an easy answer for this: the protocols used by the Internet.

"You go on the Web and you ask for information, and you get it," he says. "You don't know if it's coming from a PC or a Macintosh. You don't know the vendor."

Since Internet protocols are public, competitors could use them the way Sequoia does. But Wesker says this does not make for a threat to his business: "We defend it by being first and being better."

Once the computers can communicate with each other, there must be a way to search for the information needed.

This, too, can be done based on Internet and other existing technologies, says Jeff Mason, Sequoia's director of sales.

The third -- and most difficult -- problem is to get a system that can recognize a patient -- although some records might be stored by Social Security number, some by insurance policy number and some by other identifiers.

As Sequoia tries to develop matching techniques, "This is where it gets kind of cool, from a technical point of view," Wesker says.

Wesker and Mason also say they are confident that their system can provide more privacy than paper records, although someone else -- health providers or government -- will decide the rules for who gets access to what records.

Sequoia is getting $1.9 million from the Advanced Technology Program of the National Institute of Standards and Technology, part of the U.S. Department of Commerce, for the two-year project. Sequoia will kick in the balance of the $2.3 million cost.

Michael Baum, an NIST spokesman, said the grant program is designed "to encourage research in technologies potentially important to the U.S. economy, but where the technical risk is sufficiently large that is it not practical for industry to pursue it on their own."

Sequoia's was one of six winning proposals -- of 94 submitted -- in the "information infrastructure for health care" category, Baum said.

There was one other Maryland winner in that category, HT Medical Systems Inc. of Rockville, for a "pre-operative decision support system."

There were two Maryland biotechnology winners, Osiris Therapeutics Inc. of Baltimore, for a project in heart muscle regeneration, and Large Scale Biology Corp. of Rockville, for a project in genetic analysis.